There's Social Security Disability As It Really Exists And Social Security Disability As Members Of Congress Imagine It To Be

According to the 2015 annual report from the Social Security system’s trustees, the SSDI [Social Security Disability Insurance] trust fund will run out in late 2016. ...

SSDI was established as an insurance program for the “totally and permanently disabled.” [You're putting it in quotes but the phrase "totally and permanently disabled" has never been part of SSDI. Not now. Not ever. Depending upon how you interpret the term "total disability", it can be synonymous with chronic vegetative state. Is that the sort of definition of disability that you'd prefer? Permanence has never been required. However, the one year duration requirement that we have isn't that different from a requirement of permanence, as a practical matter.] ...

Today, nearly 300,000 Arkansans and West Virginians rely on SSDI. In
some of our counties, nearly 20% of working-age people receive SSDI
benefits. [This might be important enough to your constituents for you to actually learn something about it.]

Many of these individuals are permanently disabled, and
we’re committed to protecting this vulnerable population. But we must
also dramatically improve the program for the temporarily disabled to
help them recover and return to work. [How many temporarily disabled people do you really think receive SSDI? You have to have been or be predicted to be disabled for at least a year to be found disabled. How much ground do you think there is between a year and permanent? In the real world, there's little.]...

We must intervene early. On average, applicants wait more than a year
before getting an SSDI eligibility decision. [So, the agency needs more money so it can decide cases quicker? However, Manchin and Cotten are enthuaistic budget hawks who favor endless cuts to the federal budget.] We can use this time to
help applicants who are disabled, but have the potential for work
activity stay connected to the workforce by providing support services.
This can be done through vocational training, supportive employment,
health services, incentives for employers, and more. [All of this already exists. What more do you want?]

We also need to shift SSDI from a one-size-fits-all mindset to a
smarter approach that differentiates between the permanently disabled
and those who, with medical treatment and rehabilitation services, can
recover. [We have 50 years of evidence that there is no significant number of people drawing SSDI who have the realistic capacity to return to work on a regular basis, regardless of the assistance they receive.]

While SSA categorizes beneficiaries based on likelihood of
medical improvement, there’s no requirement to pursue rehabilitation or
medical services to prepare for a return to work. [You're attacking straw men. There's zero evidence that claimants are refusing to pursue vocational rehabilitation. Mostly, they're way too sick to take advantage of it. The idea that a claimant would avoid medical treatment in order to stay on SSDI is bizarre. We have strong evidence that this virtually never happens.] We need to help
individuals with temporary disabilities gain access to rehabilitation
and recovery services and offer a timeline to re-enter the workforce. [They already have such access. It doesn't work. There's no reason to believe that it will ever work] ...

I suppose I shouldn't complain. It's better for Manchin and Cotton to concentrate upon worthless ideas than upon dangerous ideas.

10 comments:

Anonymous
said...

I happen to believe that we DO need more and better vocational rehabilitation services, if for no other reason than to get help to those who aren't going to qualify for SSD but who cannot return to their past work. You say that we have evidence that vocational rehab services don't work, yet in many states the services are lackluster, at best, and aren't offering much to anyone. Other than to dispute this aspect of your post, I agree with it.

9:45: "You say that we have evidence that vocational rehab services don't work, yet in may states the services are lackluster, at best, are aren't offering much to anyone."

This is an issue of proper FUNDING, which Congress certainly isn't going to provide. At the state level, I've seen our state slash and diminish our voc rehab services to a shell of what it used to provide 10 years ago.

I think Manchin and Cotton live in the real world a bit more than you condescendingly claim they do. They aren't imagining that the incidence of disability in their states is double the national rate and in some counties seven to eight times more prevalent. Is this not a phenomenon worthy of at least some sort of attention, at least from local policymakers?

It is undeniable that there are pockets in this country where getting "on disability" has become acculturated, perversely, as a life goal for a significant segment of the population. Even if only a minority end up making it onto the rolls, this has ill effects far beyond just the monetary costs. This mindset itself is corrosive socially and helps to keep generations trapped in cycles of dependence and poverty.

I mean, if it is a real-world fact that (as you constantly harp upon) the bar for getting on disability is extremely high, and that therefore nearly everyone on disability is too sick to ever return to work, then it is also a real-world fact that there should NEVER be any county in the country where one out of every five working-age people is disabled and will never resume working, absent some sort of hyperlocal disaster. Coal mining and poultry processing are tough jobs but they don't permanently disable vast majorities of the people who ever do them. Something else is obviously going on in certain parts of this country. Why can you not ever even acknowledge this?

Now, reasonable people can disagree about how to combat the problem, and maybe Manchin and Cotton's work incentive ideas aren't the answer. But you refuse to even acknowledge the existence of the problem in the first place, in some absurdly ideologically rigid belief that everything is a zero-sum game, that any act that is not in service of expanding the program must be opposed, and that anyone who doesn't share your politics is irrational if not outright evil. I mean, really: Manchin and Cotton want "endless" cuts to the federal budget? Do you want "endless" expansion of the federal budget? Grow up.

The adults who make up the Senate, SSA, and indeed the federal government and country at large, are big enough to walk and chew gum at the same time. Outliers, whether they are local disability clusters or high-volume/high-approval ALJs or whatever, may not be the biggest problems in the world but they are problems worthy of some people devoting some of their time to doing something about them, while at the same time other things can be done about other problems more important to you. You might try courting some potential allies for a change rather than demonizing them.

Well, to 11:13 a.m. re certain parts of the country...in my part of the country, the deep south, what is going on with those hard jobs like poultry processing is a lack of medical care. A person can't get on Medicaid just for being poor in those states that failed to enact Medicaid expansion. So you have those physically demanding jobs, poverty despite employment, poor health habits, and no medical care, and it means that people are in worse shape than they could otherwise be.

Having lived in West Virginia, it is obvious that the population as a whole is poorly educated (think not even a high school diploma), has lack of access to good health care (NPR said West Virginia has the highest percentage of edentulous folks in the nation -- and tooth health is directly related to heart and other health problems), and poor job prospects (coal mining is the most common -- you try doing that for 20 years, it wears your body out). People live "up in the hollows" and have more insular lives than almost everywhere else. Not everyone fits this profile, but many do. Since SSA dib considers age, education, and work experience as well as medical conditions, all these factors contribute to higher rates of dib.

My father lived in WV and I can see why some counties have such a high population of people on DIB. For boys getting out of high school with little education(which is most of the high school graduates, regrettably), you have a choice- get paid $60k a year doing dangerous work in the mines or make under $20k at Walmart watching your friends spend money in the Sporting Goods Dept.

I'm not sure about chicken plucking in Arkansas, but coal mining is dangerous work. If you can avoid the workplace disfigurements, there's a few cancers and respiratory diseases to catch. And that's not to say anything about day in, day out brute physical labor. Even with modern technology, those jobs are still physically intensive.

Disability is much more than simply looking at someone and making a determination on their credibility. For people who work in this business, we know it involves medical records, education (including the ability to be retrained), work experience, and job availability. All of these factors work together to make a determination.

And what else is this "something else" going on in these parts of the country? I'm curious to hear your theories.

Even the gritty coal mining jobs are almost gone. Since coal is the basis of the economy, tons of other jobs have vanished as well. There are several areas that now resemble ghost towns.

With no job prospects, the able-bodied have fled the area in search of work - leaving behind the elderly and disabled. Thus, the high disability rate.

Another factor to consider.... West Virginians tend to be clannish - meaning they have unusually strong family ties. Most leave home in search of work. Many come back home to live with family if they get injured or sick. The DIB claim gets filed in WV. These socio-economic factors certainly skew the numbers.

I've got no problem with Congress providing more help for people with disabilities who want to work. Some would benefit. There's a reality check involved with that though, and I am speaking with decades of experience in the process as well as helping people with disabilities find work.

1. Besides simplifying work incentives, it means allocating more resources to good vocational rehabilitation and other supportive programs (housing, medical treatment, social work, case management, transportation, etc.). If you get to know the population in question you quickly realize how interconnected these issues are, and how vital they are to successful employment for people with disabilities. Unfortunately, some in Congress and in state government view funding such services as increasing the size of government and politically they are very opposed to it.

2. Even if #1 were politically possible, there should be no expectation that it will significantly reduce the number of SSD and SSI disability beneficiaries for the reasons Charles mentioned. The number it would help is a low single digit percentage of beneficiaries, at best.

3. Quicker determinations I agree with. It's not happening without an increase in funding to SSA for the resources to do those quicker determinations. My understanding is that SSA submits detailed budget proposals to Congress that lay out what's needed to increase the capacity to get that done. Congress always approves significantly less, hence the increasing backlogs and delays that are harmful to claimants.

Hi. I think the whole program needs a reboot. I was denied for disability and Medicaid. I have mild cerebral palsy. I guess I was not disabled enough. They shouldn't deny people who really need it, and accept people who don't need it. Our state is one of the states that won't expand Medicaid either.